Complete Hurst Packet

Define: too much volume in the __________________ _________________ l. Causes: a. CHF: heart is__________, CO__________, decreased__________ perfusion, UO__________ *the volume stays in the _________________ _______________ b. RF: Kidneys aren't____________________ c. Alkaseltzer Fleets enemas All 3 have a lot of_______________ IVF with Na d. Aldosterone (steroid, mineralocorticoid) Where does aldosterone live? -Normal action: when blood volume gets low (vomiting, blood loss, etc.) →aldosterone secretion increases→ retain Na/water→ blood volume ______ ** Diseases with too much aldosterone: -also seen with liver disease and heart disease 1._________________________ 2._________________________ **Disease with too little aldosterone: 1._________________________ Hurst Review Services 4 e. ADH (anti-diuretic hormone) Normally makes you retain or diurese? Retain? _________________________ 2 ADH problems Too Much Not enough Retain Lose (diuese) Fluid Volume _________ Fluid Volume __________ SIADH DI Syndrome of Inappropriate ADH Secretion Diabetes Insipidus Urine Urine Blood Blood *Concentrated makes #’s go up specific gravity, Na *Dilute makes #’s go down ADH lives in pituitary; key words to make you think potential ADH problem: craniotomy, head injury, sinus surgery, transphenoidal hypophysectomy *Another name for anti-diuretic hormone (ADH) is Vasopressin. The drug Vasopressin (Pitressin or DDAVP (Desmopressin acetate) may be utilized as an ADH replacement in Diabetes Insipidus. Hurst Review Services 5 f. S/Sx of FVE: Distended neck veins/peripheral veins: vessels are_______________ Peripheral edema, third spacing: vessels can't hold anymore so they start to _______________ CVP: measured where? ____________________; number goes_________ More____________________....More____________________ Lung sounds: Polyuria: kidneys trying to help you_________________________ Pulse: _______________; your heart only wants fluid to go__________________ If the fluid doesn't go forward it's going to go______________into the_____________ BP: _______________ move volume.....more_______________ Weight: _______________ any acute gain or loss isn't fat-it’s fluid g. Treatment: Low Na diet Diuretics Loop *Bumex® may be given when Lasix® doesn’t work. Thiazide (HCTZ) * Watch lab work with all diuretics *Dehydration and electrolyte problems K-sparing Bed rest induces____________________ *when you are supine you perfuse your kidneys more h. Interventions: Physical Assessment Give IVF’s slowly to elderly Hurst Review Services 6 FLUID VOLUME DEFICIT: HYPOVOLEMIA Big Time Deficit=Shock